St Kitts and Nevis

Shadelle Gregory is a Global Public Health major who just completed her third year. She spent the last two weeks participating in UVA in St. Kitts and Nevis: Public Health Sciences, an intensive short-term program led by Prof. Jeanita Richardson. Read her pre-departure thoughts and reflections below.

Pre-Departure

I was always the girl who did not fit quite in with my family or classmates. I was labeled as “different” for the types of clothes I wore, the way I spoke, and for the types of food I ate (or did not eat). However, after arriving at the University of Virginia in 2015, I began to let go of my insecurities and embrace my differences. I realized that is was okay to be the “odd girl” or the person who does not “fit in” with the majority. These personal characteristics has allowed me to transcend my perceived mental and physical capacities and has granted me the privilege to fully appreciate the person that I have become. Embracing change and diverse environments and people are pivotal in my journey of self growth. I hope to take the experiences I have embodied here at the University of Virginia with me as I begin my adventures in St. Kitts and Nevis. I am currently majoring in Global Public Health where I have studied the social determinants of health and how health care systems function differently in all parts of the world. I will be able to experience the cause and effects of these ideals first hand while abroad.

An important question that needs to be asked throughout this experience is how does the health system structure/services in St. Kitts and Nevis affect the social determinants of health and vice versa? Moreover, how does it compare with health care systems in America? I have a deep passion for social justice and public health, so I am always eager to enhance my knowledge about the parallels between these two concepts. The curriculum for this course will be eye opening and fulfilling because I will able to study my passion outside of the states, which allows me to fully encompass the GPH major. I am most excited about experiencing a different culture outside of America, as this will be my first time traveling abroad. St. Kitts and Nevis is known for their amazing food (and large food portions). I am a lover of food and I am excited to try the varieties of food St. Kitts and Nevis has to offer. However, it is this very fact that contributes to their high obesity rates. I do hope to have a newfound appreciation for their culture when this experience is over. St. Kitts and Nevis are two different islands, so I am interested to see the differences and similarities between the two.

To be bluntly honest, I am nervous to go abroad for multiple reasons. A key reason is that I have never traveled abroad. The airport aspect of traveling is a little frightening due to my lack of traveling experience. Secondly, I want to make sure that I am culturally conscious of my actions so that the locals will be receptive to me. I am entering their home and do not want to overstep my position as a visitor. I am the first person in my immediate family to travel abroad, so I am overwhelmed and overjoyed to share this experience with them and for myself. It is a strange yet amazing feeling to watch your dreams come true. I am beyond grateful that I am able to embark on this journey and continue on this path of self-growth. Traveling has been a dream of mine forever, and I am ecstatic to begin this journey in St. Kitts and Nevis while taking a class for something that I am so deeply passionate about.

First Reflections

The people. The food. The land. The scenery. The homes. The simplicity of life. Island time. Abundance of brown colored people. The locals are so humble and proud of this beautiful island and have been excited to be part of my journey (unforseen to them). It makes me question (even more) why Americans are not this friendly. I have been soaking in the beauty of the island, but I wake up every morning and still cannot believe that I am here. On our first day of class, we were given a tour of the island by our driver, Robert. He is so knowledgeable about the land and history of St. Kitts. Within St. Kitts, there are small villages, all of which has access to a health clinic nearby. The homes sit right by the beach, in between small revenes, close to small shops, and surrounded by greenery. There were people riding goats, walking with their children, and simply sitting on the porch. In a country whose economy is mostly driven by tourism, Kittians run of island time. Interactions with Kittians have varied based on where I have been around the island. Locals are more hesitant to speak and smile, but those who were taxi drivers or workers at the Marriott were more friendly. Those in the tourism business are more friendly as this is their job. I understand their skepticism of Americans, and especially white people.

One of the most important aspects of this trip so for is my experience as the majority race of the country. St. Kitts and Nevis is predominately black, which is the complete opposite of the composition of America. It’s an overwhelming feeling to not be the minority of the country and to fit in at every place that I go. In America, I am the sore thumb that sticks out or one of the very few (if not the only) black student in my classes at UVa. However, when the group and I travel to different places, Kittians stare at us because we clearly are not from the island and because of the white students in our group. In America, I am used to getting stares or whispers, but it was something different about the stares we got here in St. Kitts. During a visit to Ross University, the veterinary medicine school on the island, I was shocked at the lack of colored people on the campus in a majority black island. They are separated from local Kittians, and they have better equipment and resources than the local hospital, health centers, and schools. They do not engage with the community and do not advocate for a community model of health, which is extremely important in all aspects of health. Having attended UVa, I understand what it is like to be one of the few people of color in a classroom or out in a social setting, but this experience was worse for me. I was so shocked to hear about students from different countries who came to this island and have no interaction or cultural perceptions of the place they would be living and studying. Understanding the social determinants of health is vital to helping a community better their health. The local hospital and health centers around the island emphasis a community based model. The Kittian nurses and health workers had limited resources, but do the best job they can. To have visited the local health centers and know they lack modern medical technology, it is heartbreaking to know about the equipement, power, and resources Ross University has that they do not offer or share with the community. Kittians perception of white people are tainted by their interactions with white people who attend Ross and those from America. It’s been interesting to see how race and racism functions on the island that is run by people of color. It never disappears and it reinforces that race is a social construct and is tied to health.

Public Health is more than just one’s well-being and visits to the hospital. This trip so far has highlighted even more the need to address the social determinants of health and a community based model in order to efficiently, culturally, and effectively improve the health of a population.

Latasha Jennings is a 3rd year Biology and Women, Gender Sexuality Studies Double Major. She traveled to St. Kitts and Nevis for the UVA summer class in Social Determinants of Child Health. Below are some of her photos and experiences.

Similar to our visit to Tucker Clarke Primary School, we gave presentations to the children at Ivor Walters Primary School in Nevis on asthma, how it is triggered, and how it can be managed. The goal of our presentations was to show children that they can still lead healthy, active lives with asthma.

We visited this school twice during our stay in St. Kitts. During the first visit, we presented the teachers with the books and teaching supplies that Dr. Richardson donated to the school and then briefly observed a class. During the second visit, we gave a talk to children in grades K-2 about what asthma is, what triggers it, and what they should do if they begin to have an asthma attack.

The National Museum is located in St. Kitts at the meeting point of Basseterre and Port Zante. The building in which it is housed was completed in 1894, and it used to serve as the Treasury Building for St. Kitts. It opened its doors as the National Museum for the first time in 2002.

In 2005, St. Kitts switched from an economy based on sugar cane production to one based on tourism, and Port Zante pictured above has become a tourist hotspot as a result. Cruise ships dock at the Port, and tourists spend the day shopping at the multitude of shops and craft markets located at the Port.

A press conference was held during our visit to Ivor Walters Primary School where Dr. Richardson presented the school with children’s books and teaching supplies.

We were given a tour of one of the six community health centers in Nevis by Permanent Secretary in the Ministry of Health Nicole Slack-Liburd. These health centers are located within walking distance of the communities they serve and provide primary care to the citizens of Nevis.

Teaching Assistant, Seleena Moore, along with Dr. Richardson spoke during a press conference in Nevis on the findings of the research the two have done on the social determinants of childhood asthma in St. Kitts and Nevis.

During our stay in St. Kitts, we went on a short hike into the island’s rainforest and visited the location where all of the island’s freshwater is collected. This water is filtered, treated, and piped down to the rest of the island.

This UNESCO World Heritage Site was designed by British Army Engineers and built by African slaves. Construction of the Fortress began in 1690 and continued intermittently for just over 100 years until completion. The Fortress is now a National Park that is managed by the Brimstone Hill Fortress National Park Society.